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Ultrasound, FibroScan detected liver changes in NAFLD, NASH

Contrast-enhanced ultrasound and FibroScan could potentially be used to measure and monitor any changes in the liver in patients with nonalcoholic steatohepatitis and nonalcoholic fatty liver disease, according to new data.

FibroScan (Echosens) and contrast-enhanced ultrasound (CEUS) were used to determine intrahepatic blood flow and liver stiffness in patients with nonalcoholic fatty liver disease (NAFLD; n=15), nonalcoholic steatohepatitis (NASH; n=17) and healthy controls (n=16). Each patient had 5 mL SonoVue (Bracco Imaging) injected into a peripheral vein in the left arm during a 4-second span. Researchers measured percentage of maximal contrast activity (peak), time to peak (TTP), regional blood volume (RBV), regional blood flow (RBF) and mean transit time (MTT). Liver stiffness was evaluated using FibroScan 24 to 48 hours after injection.

Portal vein (PV) analysis indicated a shorter peak percentage and decreased RBV and RBF in NAFLD (peak %, 26.3 ± 6.6; RBV, 4,202.3 ± 3,519.7; RBF, 32.5 ± 10.8) and NASH (peak %, 28.1 ± 7.3; RBV, 3,929.8 ± 1,941.3; RBF, 32.7 ± 12.1) patients compared with controls (peak %, 55.8 ± 9.9; RBV, 7,473 ± 3,281; RBF, 73.1 ± 13.9). Right liver parenchymal (LP) analysis had similar results of reduced RBV and RBF in the NAFLD and NASH groups as well those of controls. TTP in the PV was significant among NASH patients, but not the NAFLD group or controls (P<.01). TTP in the LP was longer but not significant in NASH and NAFLD patients compared with controls. Researchers observed greater liver stiffness in NASH patients vs. controls (6.4 ± 2.2 kPa vs. 4.6 ± 1.5 kPa; P<.05).

“CEUS evaluated by Qontrast might be able to quantify functional vascular liver changes not otherwise detectable with any other noninvasive procedure and before the development of fibrosis,” the researchers concluded. “The combined use of FibroScan and Qontrast-assisted CEUS could be helpful in assessing the level of disease and could be potentially useful for monitoring the effects of therapeutic interventions.”

Disclosure: Relevant financial disclosures were not provided by researchers.